Pomalidomide Use Outcomes in Patients with Relapse/Refractory Multiple Myeloma and Chronic Kidney Disease: A Real-World, Population-Based Cohort Study
Bibliographic record
Abstract
BackgroundPomalidomide-based regimens are standard for relapsed/refractory multiple myeloma. Patients with advanced CKD are often excluded from trials. We conducted a population-based cohort study in Ontario, Canada, to evaluate outcomes of pomalidomide-based therapy across kidney disease groups. MethodsAdults (≥18 years) with relapsed/refractory multiple myeloma treated with pomalidomide were included. Primary outcome was all-cause mortality; secondary outcomes were adverse kidney events, time-to-next treatment, kidney function response, and safety. ResultsAmong 748 patients, 440 had preserved kidney function, 210 had moderate CKD, and 98 had advanced CKD. Mean age was 70.2 years; 43.3% were women. Advanced CKD was associated to higher mortality (aHR 1.37, 95% CI 1.06–1.78) and adverse kidney events (aHR 1.70, 95% CI 1.03–2.35). Kidney response and safety were similar across kidney function groups. ConclusionsAdvanced CKD was associated with reduced survival and higher adverse kidney events, but kidney recovery and safety outcomes were similar.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".